Individual
MR. JON GERALD ALDRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
20 W PARK ST, SUITE 214, LEBANON, NH 03766-1378
(603) 448-4370
(603) 448-4370
Mailing address
20 W PARK ST, SUITE 214, LEBANON, NH 03766-1378
(603) 448-4370
(603) 448-4370
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
394
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1408363Y0NH01
ANTHEM
NH
01
—
29080
VT BLUE SHIELD
VT
05
—
30006909
—
NH
01
—
341027
MVP HEALTH CARE
NH
01
—
H08421
CHAMPUS
NH
05
—
OVN-0653
—
VT
Enumeration date
02/04/2007
Last updated
07/08/2007
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